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U.S. Healthcare Spending Hit Nearly $10,000 A Person In 2015

Spending on health care in the U.S. hit $3.2 trillion in 2015, increasing 5.8% from 2014. This works out to $9,990 per person in the U.S., and nearly 18% of the nation’s gross domestic product (GDP). Factors that drove such significant spending growth included increases in private health insurance coverage owing to the Affordable Care Act (ACA) coverage (7.2%), and spending on physician services (7.2%) and hospital care (5.6%). Prescription drug spending grew by 9% between 2014 and 2015 (a topic which I’ll cover in tomorrow’s Health Populi discussing IMS Institute’s latest report into global medicines spending). The topic of

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Both Healthcare Prices and Use of Services Driving Up Spending

Health care spending grew 4.6% in 2015, higher than the rise in either 2013 or 2014, according to the 2015 Health Care Cost and Utilization Report published by HCCI, the Health Care Cost Institute. The key contributors to health care spending by percentage were, first and foremost, prescription drugs which rose 9% in the year — notably, specialty medicines like anti-infective drugs (such as those for Hepatitis C and HIV) costing on average $83 per “filled day.” This cost doubled from $53 per person in 2012 to $101 per person in 2015. Hospital costs saw the second greatest percentage price increase

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Most Doctors With EHRs Still Not Taking Advantage of Their Benefits

Interoperability of medical records across physician offices remained elusive in 2015, according to the latest data reported out by the Centers for Disease Control (CDC). About 8 in 10 U.S. physicians had an electronic health records system in 2015. One-third of these doctors electronically sent, received, integrated or searched for patient health information — indicating that most physicians still aren’t using EHRs to their fullest extent. These findings come from the NCHS Data Brief from the CDC, State Variation in Electronic Sharing of Information in Physician Offices: United States, 2015. The bar chart illustrates the percentage of U.S. office-based doctors

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Building the Primary Care Dream Team

“Today’s primary care won’t work tomorrow,” given the shortage of primary care providers (PCPs) and the need to do more in healthcare with fewer resources in the emerging value-based economy. So let’s re-imagine primary care models, PwC asserts, and makes the case in their report, ROI for primary care: Building the dream team. What’s the financial impact of this dream team on healthcare providers? It’s potentially $1.2 million in savings for every 10,000 patients served, PwC calculates. Historically, physicians have been loath to share their work with non-physicians because of how doctors have been paid — on the basis of fee-for-service,

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Doctors Are Growing to Like Digital Health Tools, Says the AMA

Notwithstanding the head of the AMA recently referring to digital health technologies as “snake oil,” it appears that one-half of physicians is keen on digital health. And scale, not age, matters when it comes to doctors using digital health tools. The American Medical Association (AMA) surveyed physicians on their use of digital health tools, finding that primary care physicians (PCPs) and doctors working in larger and more complex practices tend to be more digital. In Physicians’ motivations and requirements for adopting digital clinical tools, the AMA’s digital health study, “Physicians are optimistic about digital health innovation and its game-changing potential

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U.S. Health Spending Will Comprise 20% of GDP in 2025

Spending on health care in America will comprise $1 in every $5 of gross domestic product in 2025, according to National Health Expenditure Projections, 2015-25: Economy, Prices, And Aging Expected to Shape Spending and Enrollment, featured in the Health Affairs July 2016 issue. Details on national health spending are shown by line item in the table, excerpted from the article. Health spending will grow by 5.8% per year, on average, between 2015 and 2025, based on the calculations by the actuarial team from the Centers for Medicare and Medicaid Services (CMS), authors of the study. The team noted that the Affordable Care

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Most Wired Hospitals Spending on Cybersecurity, Telehealth and Population Health

Investing information technology dollars in telehealth and mobile platforms, patient engagement, and cybersecurity are major focuses for leading IT-savvy hospitals in America, according to the 2016 Most Wired survey of healthcare organizations, released in July 2016 sponsored by Hospitals and Health Networks and Health Forum, a division of the American Hospitals Association. This survey, in its 18th year, has become an important benchmark measuring the adoption of information technology tools and services among American hospitals and health systems. The complete list of Most Wired hospitals for 2016 can be found here. The most popular telehealth services offered by the Most Wired hospitals are

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Accountable Care Will Happen Best When Patients Engage

Technology alone won’t improve health care in America, especially in people with chronic health problems don’t want to use it. Furthermore, too many clinicians who have invested in digital health technologies (namely, electronic health records systems), aren’t fully taking advantage of what they have. This and other health care realities are explored in Better Together: Patient Expectations and the Accountability Gap, based on a consumer survey conducted by Nielsen Strategic Health Perspectives for the Council of Accountable Physician Practices, an affiliate of the American Medical Group Foundation. The survey polled 30,007 consumers in March 2016, and combined physician data culled from Nielsen’s

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The Primacy of People as Health/Care Goes Digital: Accenture

Digital platforms and tools are fast-advancing in all industries, and especially in health and health care. But it’s people-first, and digital PLUS analog, based on Accenture’s latest forecast of five macro technology trends. The five forces are: Intelligent automation – 70% of health executives expect to invest more in artificial intelligence; Liquid workforce – 42% of health/care workers are expected to be contractors or free agents within organizations within 3 years’ Platform economy – 10x growth is expected in application programming interfaces (APIs) in the next five years, which will enable data to liquidly move across healthcare platforms Predictable disruption

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What Health Care Can Learn from the Blood Clot Community

  “Our goal is to create an aware and engaged, irritating set of patients who create a dialogue with health care providers once they’ve had a [blood] clot,” explained Randy Fenninger, CEO of the National Blood Clot Alliance (NBCA). NBCA’s tagline and hashtag is “Stop the Clot.” Welcome to the multi-stakeholder community involved with deep vein thrombosis (DVT) and, clinically speaking, Venous Thromboembolism (VTE). We’re talking blood clots, and the public health burden of this condition is big: it’s a leading cause of death and disability. One in 4 people in the world die of conditions caused by thrombosis. I had

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Honoring the Doctor-Patient Relationship

  March 30 this week was National Doctors Day, which was proclaimed a national celebration by President George Bush in 1991. But as I’ve written through this week here on Health Populi, doctors may enjoy prestige on the outside, but they’re hurting on the inside — both economically in medical/business practices, and emotionally in their personal career-lives. Patients tend to like, even love, their personal physicians based on years of consumer polls on the topic (usually themed, “love my own doctor, hate the health care system”). But physicians and their patients aren’t on the same page, literally, when it comes

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Being A Doctor Is Highly Prestigious. A Politician? Don’t Ask.

The most prestigious occupation in America is being a doctor, agreed by 90% of U.S. adults. 90% of them would also encourage their child to pursue a career in medicine. Politician? 70% of parents would discourage a child from pursuing that career path, according to The Harris Poll’s survey on occupational prestige. The top-prestige professions are: Doctor, agreed by 90% Scientist, 83% Firefighter, 80% Military officer, 78% Engineer, 76% Nurse, 76% Architect, 72% Emergency medical tech, 72% Veterinarian, 71% Police office, 67%% Teacher, 65% Entrepreneur, 65% Chef, 62% Athlete, 62% Lawyer, 62% Musician, 61%. All other professions fell below 60%

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The Patient-Physician Experience Gap

As patients continue to grow health consumer muscles, their ability to vote with their feet for health care services and products grows. That’s why it’s crucial for health care providers to understand how patients perceive their quality and service levels, explained in Patient Experience: It’s Time to Rethink the Consumer Healthcare Journey, a survey report from GE Healthcare Camden Group and Prophet, a brand and marketing consultancy. 3 in 4 frequent healthcare consumers say they are frustrated with their services. One-half of less-frequent patients are frustrated. Patients and physicians are on different pages when it comes to evaluating the health care

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Consumers Take Better Preventive Care of Pets Than Themselves, CIGNA Finds

Nine in 10 pet owners know when their dog or cat is due for their shots. Eight in 10 women know the frequency with which they get manicures and pedicures. 80% of men know the mileage between old changes. But only 50% of family health care decision makers know their blood pressure, and only 20% know their biometric numbers like cholesterol and BMI. Americans are great at doing preventive care for their pets and automobiles; but not so much for their own bodies and health, finds the report CIGNA Preventive Care Research, a survey of 1,000 U.S. consumers between 25 and

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Diagnosis: Acute Health Care Angst In America

There’s an overall feeling of angst about healthcare in America among both health care consumers and the people who provide care — physicians and administrators. On one thing most healthcare consumers and providers (can agree: that the U.S. health care system is on the wrong track.  Another area of commonality between consumers and providers regards privacy and security of health information: while healthcare providers will continue to increase investments in digital health tools and electronic health records systems, both providers and consumers are concerned about the security of personal health information. In How We View Healthcare in America: Consumer and Provider Perspectives,

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Yes, Virginia, There Really Are Healthcare Consumers: McKinsey

“There’s no such thing as a healthcare consumer. No one really wants to consume healthcare,” naysayers tell me, critical of my all health-consmer-all-the-time bully pulpit. But, touché to my health consumer-critics! I’ve more evidence refuting the healthcare consumer detractors from McKinsey in their research report, Debunking common myths about healthcare consumerism, from the team working in McKinsey’s Healthcare Systems and Services Practice. Their survey research among over 11,000 U.S. adults uncovered 8 myths about the emerging American health consumer, including: Healthcare is different from other industries Consumers know what they want from healthcare and what drives their decisions Most consumers

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Insurance Should Pay For End-of-Life Conversation, Most Patients Say

8 in 10 people in the U.S. say that Medicare as well as private health insurance plans should pay for discussions held between patients and doctors about hatlhcare at the end-of-life. The September 2015 Kaiser Family Foundation Health Tracking Poll asks people their opinions about talking end-of-life with their doctors. The vast majority of people support the concept and physicians being paid for holding such conversations in doctor-patient relationship. The question is germane because the Obama Administration has announced plans to pay doctors for office visits to discuss end-of-life (EOL) issues with Medicare patients. There isn’t a huge variation across

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36 Mobile Health Apps Account for Half of All Downloads

Of the over 165,000 mobile health (mHealth) apps available in the Apple iTunes and Google Play (Android) stores, 36 are responsible for one-half of all downloads, based on IMS Institute‘s latest research into Patient Adoption of mHealth: Use, Evidence and Remaining Barriers to Mainstream Adoption published today. This report updates IMS Institute’s 2013 report on mHealth, covered here in Health Populi. For the 2015 research, IMS Institute looked at the state of mHealth apps, number and type, uptake and usage, evidence of the impact apps have on patient care, and consideration of barriers and progress made for apps becoming a

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All women are health workers

The spiritual and emotional top the physical in women’s definition of “health,” based on a multi-country survey conducted in Brazil, Germany, Japan, the UK and the U.S. The Power of the Purse, a research project sponsored by the Center for Talent Innovation, underscores women’s primary role as Chief Medical Officers in their families and social networks. The research was sponsored by health industry leaders including Aetna, Bristol-Myers Squibb, Cardinal Health, Eli Lilly and Company, Johnson & Johnson, Merck & Co., Merck KGaA, MetLife, Pfizer, PwC, Strategy&, Teva, and WPP. The study’s summary infographic is titled How the Healthcare Industry Fails

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It’s a retail health world: consumers at the helm of health/care

Retail health v1.0 encompassed the pharmacy, then embraced urgent care and retail health clinics co-located in brick-and-mortar pharmacy chain stores. In v2.0, retail health encompasses all health/care, really, because people, patients and consumers are essentially self-insured up to the point when their health plan kicks in some cash. The high-deductible health plan era is ushering in the retail health era, broadly writ. Hospitals & Health Networks magazine (HHN) ran a story titled Think Like a Retailer to Engage Patients, covering founder of WEGO Health Jack Barrette‘s and my panel presentation at the 2015 HIMSS conference in Chicago last week. Writer

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Health is where we live, work, and shop…at Walgreens

Alex Gourley, President of The Walgreen Company, addressed the capacity crowd at HIMSS15 in Chicago on 13th April 2015, saying his company’s goal is to “make good health easier.” Remember that HIMSS is the “Health Information and Management Systems Society” — in short, the mammoth health IT conference that this year has attracted over 41,000 health computerfolk from around the world. So what’s a nice pharmacy like you, Walgreens, doing in a Place like McCormick amidst 1,200+ health/tech vendors?  If you believe that health is a product of lifstyle behaviors at least as much as health “care” services (what our

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She’s just not that into connecting with you (yet), doctor

Just 1 in 5 health-insured people with a primary care provider use the web to look at their health data, and fewer than 1 in 10 people use digital means to book appointments. Welcome to the 2015 State of the Connected Patient, a survey report from Salesforce conducted by Harris Poll among 2,095 adults in January 2015. Perhaps the title of the analysis should more appropriately be the “2015 State of the Unconnected Patient.” While most patients polled are satisfied with their PCPs and most believe doctors are sharing their health records, people lack digital engagement with their primary care providers.

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Hug your physician – chances are, s/he’s burned out

If you’re meeting with a physician in the next week or two, put on your empathy hat: chances are, they are feeling burned-out. Overall 46% of physicians report they were burned out in 2014, up from just under 40% last year. Medscape’s Physician Lifestyle Report 2015 finds that at least one-half of physicians are burned-out who work in critical care, emergency medicine, family medicine, internal medicine, general surgery, and infectious disease (including HIV). And, at least 37% of physicians are burned-out working in all other specialties, shown in the first chart. Medscape gauges doctors’ self-assessments of burnout with a lens

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Health and wellness at CES 2015 – trend-weaving the big ideas

Health is where we live, work, play and pray — my and others’ mantra if we want to truly bend (down) the cost curve and improve medical outcomes. If we’re serious about achieving the Triple Aim — improving public health, lowering spending, and enhancing the patient/health consumer experience (which can drive activation and ongoing engagement) — then you see health everywhere at the 2015 Consumer Electronics Show in Las Vegas this week. With this post, I’ll share with you the major themes I’m seeing at #CES2015 related to health, wellness, and DIYing medical care at home. The meta: from health care to self-care.

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Women worry about being bag-ladies – the health implications of financial un-wellness

My post, Even Rich Girls Worry About Being Bag Ladies, was published in the Huffington Post this week. In the analysis, I weave the results of several seminal surveys on women, money, and health that have been conducted in the past few months. The bottom-line: even the most affluent women are financially stressed, and that stress is leading women to re-define what it means to be personally successful. When it comes to personal health, financial wellness is part of overall well-being, as defined by women who place being healthy above having money. Avoiding debt is the nuance here, not amassing

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Hug your doctor: s/he needs it, according to the 2014 Physician Foundation survey

While the medical profession has reached a so-called state of crisis, there’s also a “changing of the guard” happening in the profession where doctors are re-imagining what it means to be physician in the era of value-based, technology-enabled health care. Such is the state of the union — or dis-union — of the U.S. medical profession. The 2014 Survey of America’s Physicians from Physicians Foundation finds that 4 in 5 U.S. doctors are over-extended or reaching full capacity in their practices. This is up from 2012. Only 19% of doctors say they have time to see more patients. That may be

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Crossing the digital health chasm between consumers and providers – talking with Dr. Eric Topol

More than twice as many patients than physicians are embracing consumers’ use of new digital technologies to self-diagnose medical conditions on their own. On the other hand, 91% of doctors are concerned about giving patients access to their detailed electronic health records, anticipating patients will feel anxious about the results; only 34% of consumers are concerned about anxiety-due-to-EHR-exposure. Welcome to the digital health chasm, that gap between what consumers want out of digital health, and what doctors believe patients can handle at this stage in EHR adoption in doctors’ offices and in patients’ lives. I have the video of Jack

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Do EHRs “chill” patient disclosures to clinicians?

Patients are concerned about private risks of personal health data, resulting in some patients not disclosing certain information to health providers to protect their perceived EHR privacy and security risks. Peoples’ mixed feelings about sharing personal health information with their providers and EHRs is explored in The double-edged sword of electronic health records: implications for patient disclosure, published in the July 2014 issue of JAMIA, the Journal of the American Medical Informatics Association (AMIA). “The perception of the [EHR] technology may elicit non-disclosure as a privacy-protecting behavior,” the authors warn. Celeste Campos-Castillo and Denise Anthony, the paper’s researchers who work in

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Dialing Dr. Verizon – the telecomms company launches virtual house calls

Expanding its wireless footprint in health care, Verizon, the telecommunications company, announced the start of Verizon Virtual Visits today. The program will be marketed to employers and health plans to enable patients to see doctors at home or when traveling, via Verizon’s wireless network. I spoke with Christine Izui, Verizon’s quality officer, mobile health solution, earlier this week about Virtual Visits. We discussed the market forces that support the growth of telehealth and, in particular, physician visits “anywhere:” There is an under-supply and poor distribution of primary care doctors and certain specialties around the U.S. Employers and health plan sponsors are

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Doctors become health economists

The rising costs of health care in America, and consumers’ growing cost burdens, has many impacts on the U.S. health ecosystem. In particular, patients have been self-rationing due to costs, without necessarily paying attention to quality or medical outcomes. Doctors have begun to pay more attention to costs and their impacts on patients in their practices, addressed in today’s New York Times article, Treatment costs could influence doctors’ advice to patients. Andrew Pollack writes in the Times about the morphing role of doctors, some of whom are taking on the mantle of being a “steward of society,” as characterized by

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People want to DIY with pharma

In our increasingly-DIY society, most consumers expect high levels of access and customer service from the organizations with whom we engage. With more consumers reaching into their pockets to pay for health services and products, the health industry is increasingly a retail-facing environment. So expect quality service levels from their healthcare touch points. The pharmaceutical and prescription drug touch point is not exempt from this expectation, as learned by an Accenture survey analyzed in Great Expectations: Why Pharma Companies Can’t Ignore Patient Services. As the first picture shows, 70% of patients think pharma companies are responsible for bundling information and services

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HIMSS14 Monday Morning Quarterback – The Key Takeaways

Returning to terra firma following last week’s convening of the 2014 annual HIMSS conference…taking some time off for family, a funeral, the Oscars, and dealing with yet another snowstorm…I now take a fresh look back at #HIMSS14 at key messages. In random order, the syntheses are: Healthcare in America has entered an era of doing more, with less...and health information technology is a strategic investment for doing so. The operational beacon going forward is moving toward The Triple Aim: building population health, enhancing the patient’s experience, and lowering costs per patient. The CEO of Aetna, Mark Bertolini, spoke of the

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Where’s TripAdvisor for health care? JAMA on physician ratings sites

As more U.S. health citizens enroll in high-deductible health plans – now representing about 30% of health-insured people in America – health plan members are being called on to play the role of consumer. Among the most important choices the health consumer makes is for a physician. Ratings sites and health care report cards ranking doctors by various characteristics have been in the market for over a decade. However, little has been known on the public’s knowledge about the availability of these information sources, nor of peoples’ use of physician rating sites. This question is addressed in Public Awareness, Perception, and

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3 Things I Know About Health Care in 2014

We who are charged with forecasting the future of health and health care live in a world of scenario planning, placing bets on certainties (what we know we know), uncertainties (what we know we don’t know), and wild cards — those phenomena that, if they happen in the real world, blow our forecasts to smithereens, forcing a tabula rasa for a new-and-improved forecast. There are many more uncertainties than certainties challenging the tea leaves for the new year, including the changing role of health insurance companies and how they will respond to the Affordable Care Act implementation and changing mandates

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Doctor respect, nurse trust – the yin/yang of team-based care

7 in 10 people in the U.S. see a doctor for their health care, and prefer seeing a doctor over a nurse practitioner, based on a poll Ipsos conducted on behalf of the American Academy of Family Physicians. What do people seek in a doctor? Knowledge, state-of-the-art treatments, experience and trustworthiness are the top traits people seek in health providers overall. Ipsos probed further into various traits for clinicians (including doctors, nurses and NPs), asking which of these factors were embodied in the health professional people want to receive care from. The most important attributes for doctors were: Who I want

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Investing in technology that lowers health costs – the growing role of mobile

At the Venture+ Forum at the 2013 Mobile Health Summit yesterday, Lisa Suennen, Managing Director of Psilos Ventures was asked what she and her venture capital fund look for in choosing new investments for their health care portfolio. She succinctly said, “technologies that lower costs.” With nearly $1 in $5 of the U.S. economy attributable to health spending, Lisa’s got a point. Technology in U.S. health care has been mostly additive and expense-inducing, not reducing: fax machines and printers, for example, continue to proliferate in health care settings as part of “networking,” and once you add a new clinical technology

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More chronically ill people use online health resources – but they’re not so social, Pew finds

People who are diagnosed with at least one chronic medical condition are more likely to seek information online, use social media to understand peer patients’ reviews on drugs and treatments, and learn from other patients about their personal health experiences. While that’s encouraging news for a health empowerment headline, the underlying challenge that should prevent congratulatory fist-bumps among patient-engagement proponents is that people living with chronic disease are less likely to have internet access. Why? Because chronically ill people tend to be older and less educated, and they’re also less likely to be working. Simply put, “People living with chronic

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Make health care “feel” more like retail via transparency

Consumers who are well-covered by health insurance are in favor of talking about costs with their doctors. This research finding illustrates the fact that price transparency in health care isn’t just the concern of un- and under-insured people, but that shining the light on the price of health care is everybody’s business. But it’s also the case that most physicians aren’t yet involved in these health-financial conversations with their patients. Two studies presented at the recent 2013 annual meeting of the American Society of Clinical Oncology (ASCO) learned that patients are keen to know more about health care costs from

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Health costs up, credit down: health consumers face tightening credit markets in the face of rising medical costs

People who received health care in the U.S. between the second quarters of 2012 and 2013 faced 38% higher out-of-pocket costs, growing from $1,862 to $2,568 in just one year. These were payments for common procedures like joint replacements, Caesarean sections, and normal births. At the same time, consumers’ access to revolving credit lines fell by $1,000 over the twelve months. (Credit lines here include bank-issued credit cards, store credit cards, and home equity loans). The TransUnion Healthcare Report from TransUnion, the credit information company, paints a picture of tightening money for all consumers in the face of rising household

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Moneytalk: why doctors and patients should talk about health finances

  Money and health are two things most people don’t like to talk about. But if people and their doctors spoke more about health and finance, outcomes (both fiscal and physical) could improve. In late October 2013, Best Practices for Communicating with Patients on Financial Matters were published by the Healthcare Financial Management Association (HFMA). Michael Leavitt, former head of the Department of Health and Human Services, led the year-long development effort on behalf of HFMA, with input from patient advocates, the American Hospital Association, America’s Health Insurance Plans, the American Academy of Family Physicians and the National Patient Advocate Foundation, along

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Innovating and thriving in value-based health – collaboration required

In health care, when money is tight, labor inputs like nurses and doctors stretched, and patients wanting to be treated like beloved Amazon consumers, what do you do? Why, innovate and thrive. This audacious Holy Grail was the topic for a panel II moderated today at the Connected Health Symposium, sponsored by Partners Heathcare, the Boston health system that includes Harvard’s hospitals and other blue chip health providers around the region. My panelists were 3 health ecosystem players who were not your typical discussants at this sort of meeting: none wore bow ties, and all were very entrepreneurial: Jeremy Delinsky

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A new medical side-effect: out-of-pocket health care costs

When we say the phrase “side effects,” what do we think of? The FDA says that “all medicines have benefits and risks. The risks of medicines are the chances that something unwanted or unexpected could happen to you when you use them. Risks could be less serious things, such as an upset stomach, or more serious things, such as liver damage.” There’s a new risk in town in health care, and it’s the equivalent of an upset stomach when it comes to a co-pay for a branded on-formulary drug, or liver damage if it involves a coinsurance percent of “retail”

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Consumers’ out-of-pocket health costs rising faster than wages – and a surprising hit from generic drug prices

U.S. health consumers faced greater out-of-pocket health care costs in 2012, especially for outpatient services (think: doctors’ visits) and generic drugs, as presented in The 2012 Health Care Cost and Utilization Report  from the Health Care Cost Institute (HCCI) published in September 2013. At the same time between 2011 and 2012, wages grew about 3%, remaining fairly flat over the past decade as health care costs continued to grow much faster. HCCI found that per capita (per person) out-of-pocket growth for outpatient visits amounted to an average of $118 between 2011 and 2012. But the biggest share of out-of-pocket costs for

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The FDA Has Spoken, and It Will Regulate “Some” mHealth Apps

The FDA has spoken: there are 2 statutory definitions for a mobile health tool as a “medical device” that the Agency says it has regulatory oversight: To be used as an accessory to a regulated medical device, or To transform a mobile platform into a regulated medical device. On page 8 of the Guidance for Industry and Food and Drug Administration Staff, you can read the FDA’s expanded definition of a mobile health app as being: “…intended for use in performing a medical device function (i.e. for diagnosis of disease or other conditions, or the cure, mitigation, treatment, or prevention

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Healing the Patient-Doctor Relationship with Health IT

A cadre of pioneering Americans has been meaningfully using personal health information technology (PHIT), largely outside of the U.S. health care system. These applications include self-tracking and wearable health technologies, mobile health apps, and digital medical tracking devices like glucometers that streamline tracking and recording blood glucose levels. In the meantime, only 21% of doctors surveyed by Accenture currently allow patients to have online access to their medical summary or patient chart – very basic components of the electronic health record. We know what’s primarily driving health providers’ adoption of health IT: namely, the HITECH Act’s provisions for incentives. But

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Health information search online, an hour a week. Time with a doctor? An hour a year.

In game-scoring unit terms, 52 is the number of hours an average American spends seeking health information online each year. The 1 (hour) is roughly equivalent to the approximate total time a patient spends with a physician (an average of 3 visits, with an average time per vision of 20 minutes). Thus, 52:1. This means that the average U.S. health consumer spends much more time DIYing her health using digital information resources than speaking face-to-face with their physician in the doctor’s office. Still, the physician continues to be a go-to source for health information, according to Makovsky, a health communications

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People are growing their health-consumer muscles in 2013

  Most Americans are concerned about their ability to for medical bills, even when they have health insurance. As a result, most are comfortable asking their doctor about how much their medical treatment will cost. People are becoming savvier health care shoppers largely because they have to: 37% of people in the U.S. have an annual health insurance deductible over $2,000, according to the Spring/Summer 2013 Altarum Institute Survey of Consumer Health Care Opinion, published on 11th July 2013. Many of the media stories coming out of the Altarum survey since its publication have been about people and their trust in

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In the US health care cost game, doctors have seen the enemy – and it’s not them

When it comes to who’s most responsible for reducing the cost of health care in America, most doctors put the onus on trial lawyers, health insurance companies, pharma and medical device manufacturers, hospitals, and even patients. But physicians themselves ? Not so much responsibility – only 36% of doctors polled said doctors should assume major responsibility in reducing health care costs. And, in particular, most U.S. physicians have no enthusiasm for reducing health care costs by changing payment models, like penalizing providers for hospital re-admissions or paying a group of doctors a fixed, bundled price for managing population health. Limiting

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What to expect from health care between now and 2018

Employers who provide health insurance are getting much more aggressive in 2013 and beyond in terms of increasing employees’ responsibilities for staying well and taking our meds, shopping for services based on cost and value, and paying doctors based on their success with patients’ health outcomes and quality of care. Furthermore, nearly one-half expect that technologies like telemedicine, mobile health apps, and health kiosks in the back of grocery stores and pharmacies are expected to change the way people regularly receive health care. What’s behind this? Increasing health care costs, to be sure, explains the 18th annual survey from the National

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The promise of ObamaCare isn’t comforting Americans worrying about money and health in 2013

In June 2013, even though news about the economy and jobs is more positive and ObamaCare’s promise of health insurance for the uninsured will soon kick in, most Americans are concerned about (1) money and (2) the costs of health care. The Kaiser Health Tracking poll of June 2013 paints an America worried about personal finances and health, and pretty clueless about health reform – in particular, the advent of health insurance exchanges. Among the 25% of people who have seen media coverage about the Affordable Care Act (alternatively referred to broadly as “health reform” or specifically as “ObamaCare”), 3

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Health consumers, meet the medical bank

Health consumers, meet a new player in your health care world: the bank. Financial services companies will play a growing role in U.S. health care as patients morph into health care consumers responsible for making more money-based decisions about their health care. This shift could make paying for health care just like paying other bills in the consumer retail market. And that’s a new role for health providers – doctors and hospitals – to fill. The Impact of Growing Patient Financial Responsibility on Healthcare Providers, prepared for Citi Enterprise Payments by Boundary Information Group, discusses what the impact of consumers’ payments in

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As health cost increases moderate, consumers will pay more: will they seek less expensive care?

While there is big uncertainty about how health reform will roll out in 2014, and who will opt into the new (and improved?) system, health cost growth will slow to 6.5% signalling a trend of moderating medical costs in America. Even though more newly-insured people may seek care in 2014, the costs per “unit” (visit, pill, therapy encounter) should stay fairly level – at some of the lowest levels since the U.S. started to gauge national health spending in 1960. That’s due to “the imperative to do more with less has paved the way for a true transformation of the

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The part-time medical home: retail health clinics

The number of retail health clinics will double between 2012 and 2015, according to a research brief from Accenture, Retail medical clinics: From Foe to Friend? published in June 2013. What are the driving market forces promoting the growth of retail clinics? Accenture points to a few key factors: Hospitals’ need to rationalize use of their emergency departments, which are often over-crowded and incorrectly utilized in cases of less-than-acute care. In addition, hospitals are now financially motivated under the Affordable Care Act (ACA, health reform) to reduce readmissions of patients into beds (particularly Medicare patients with acute myocardial infarction [heart attacks],

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The physician-consumer health IT chasm: most doctors lagging in online patient support tools

In the long-run, health information technology (HIT) will improve the quality of health care, according to 73% of U.S. physicians. However, about the same number (7 in 10 physicians) believe that the ROI on health IT is inflated and that implementing EHRs will cost more, not less. Still, market forces from health insurance plans, payers and consumers are driving health IT adoption, according to Deloitte’s survey report, Physician adoption of health information technology: implications for medical practice leaders and business partners. Electronic health records (EHR) adoption and meeting meaningful use (MU) Stage 1 criteria appears strongly related to the size

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1 in 5 US consumers asks a doctor for a lower-cost Rx

  With U.S. health consumers spending $45 billion out-of-pocket for prescription drugs in 2011, pharmaceutical products are morphing into retail health products. As such, as they do with any other consumer good, consumers can vote with their feet by walking away from a product purchase or making the spend based on the price of the product and its attributes, along with whether there are substitutes available in the marketplace. When it comes to prescription drugs, it’s not as clear-cut, according to the Centers for Disease Control‘s analysis of data from the 2011 National Health Interview Survey titled Strategies Used by

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The value of big data in health care = $450 billion

  Exploiting Big Data in industry is Big News these days, and nowhere is the potential for leveraging the concept greater than in health care. McKinsey & Company estimates that harnessing big data across five dimensions of health care could yield nearly one-half trillion dollars’ worth of value in The ‘big data’ revolution in healthcare. The chart summarizes McKinsey’s calculations on the value of Big Data in health care at its maximum. Before digging into the value potential, just what is Big Data in health care? Statistics and information are generated in the health care system about patients: say, during visits

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U.S. Health Costs vs. The World: Is It Still The Prices, and Are We Still Stupid?

Comparing health care prices in the U.S. with those in other developed countries is an exercise in sticker shock. The cost of a hospital day in the U.S. was, on average, $4,287 in 2012. It was $853 in France, a nation often lauded for its excellent health system and patient outcomes but with a health system that’s financially strapped. A routine office visit to a doctor cost an average of $95 in the U.S. in 2012. The same visit was priced at $30 in Canada and $30 in France, as well. A hip replacement cost $40,364 on average in the

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Most consumers will look to health insurance exchanges to buy individual plans in 2013

  As the Affordable Care Act, health reform, aka Obamacare, rolls out in 2013, American health insurance shoppers will look for sources of information they can trust on health plan quality and customer service satisfaction — as they do for automobiles, mobile phone plans, and washing machines. For many years, one of a handful of trusted sources for such insights has been J.D. Power and Associates. J.D. Power released its 2013 Member Health Plan Study (the seventh annual survey) and found that most consumers currently enrolled in a health plan have had a choice of only “one” at the time

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Do doctors want patients to have full access their own medical information? It depends.

Only one-third of U.S. physicians believe that patients should have “full access” to their electronic health records, according to Patient Access to Electronic Health Records What Does the Doctor Order?, a survey conducted by Accenture, released at HIMSS13 in March 2013. Two-thirds of doctors in the U.S. are open to patients having “limited access” to their EHRs. However, the extent to which doctors believe in full EHR access for patients depends on the type of health information contained in the record. Accenture surveyed 3,700 physicians in eight countries: Australia, Canada, England, France, Germany, Singapore, Spain and the United States, and found the doctors’

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Bill Clinton’s public health, cost-bending message thrills health IT folks at HIMSS

In 2010, the folks who supported health care reform were massacred by the polls, Bill Clinton told a rapt audience of thousands at HIMSS13 yesterday. In 2012, the folks who were against health care reform were similarly rejected. President Clinton gave the keynote speech at the annual HIMSS conference on March 6, 2013, and by the spillover, standing-room-only crowd in the largest hall at the New Orleans Convention Center, Clinton was a rock star. Proof: with still nearly an hour to go before his 1 pm speech, the auditorium was already full with only a few seats left in the

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The Accountable Care Community opportunity

“ACOs most assuredly will not…deliver the disruptive innovation that the U.S. health-care system urgently needs,” wrote Clay Christensen, godfather of disruptive innovation, et. al., in an op-ed in the Wall Street Journal of February18, 2013. In the opinion piece, Christensen and colleagues make the argument that Accountable Care Organizations (ACOs) as initially conceived won’t address several key underlying forces that keep the U.S. health care industry in stasis: Physicians’ behavior will have to change to drive cost-reduction. Clinicians will need “re-education,” the authors say, adopting evidence-based medicine and operating in lower-cost milieus. Patients’ behavior will have to change. This requires

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Required reading: TIME Magazine’s Bitter Pill Cover Story

Today’s Health Populi is devoted to Steven Brill and his colleagues at TIME magazine whose special report, Bitter Pill: Why Medical Bills Are Killing Us, is required reading for every health citizen in the United States. Among many lightbulb moments for readers, key findings from the piece are: Local hospitals are beloved charities to people who live in their market – Brill calls these institutions “Non-Profit Profitmakers). They’re the single most politically powerful player in most Congressional districts The poor and less affluent more often pay the high chargemaster (“retail list”) price for health products and services vs. the wealthy

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Physician workflow: barrier to consumer health engagement?

This week, I had a conversation with a physician whom I consider quite patient-engaged, who uses an EHR, and who works with one of the most wired health organizations in the United States. I complained to her that my user-generated data from my Bodymedia armband, Fitbit, Withings scale, among other #QuantifiedSelf devices, can’t find their way through the cloud to my doctors’ electronic health records or my patient portal. Her reaction was surprising to me. She was not so keen on the idea, saying, “It’s the physician workflow” that’s the problem. The wordle on workflow comes from Dr. Chuck Webster

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Living paycheck to paycheck: what it means for health

While 50% of Americans feel they have a sound financial position, the other half is living paycheck to paycheck. 8% say they can’t even pay for essentials. The second annual Allstate “Life Tracks” Poll finds American adults split between have’s and have not’s, with even the “have’s” feeling less than financially literate. There is an equal split between people who feel they’re in an “excellent” or “good” financial position compared with those who feel they’re in financially “fair” or “poor” shape. Men feel more financially secure than women; 3 in 4 single parents feel less well-off compared to the average

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More consumers want to make health care decisions

U.S. consumers’ desire to take an active role in their health decisions is growing, according to the Altarum Institute Survey of Consumer Health Care Opinions. 61% of people want to make health decisions either on their own (26%) or with input from their doctor (38%). The proportion of people wanting to be “completely in charge of my decisions” rose 4 percentage points in one year, from 2011. This statistic skews younger, with 33% of people 25-34 and 31% of those 35-44 wanting to be “completely in charge.” Only 17% of those 55-64 felt like being totally in charge of their

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Health reform, costs and the growing role of consumers: PwC’s tea leaves for 2013

PwC has seen the future of health care for the next year, and the crystal ball expects to see the following: Affordable Care Act implementation, with states playing lead roles The role of dual eligibles Employer’s role in health care benefits Consumers’ role in coverage Consumers’ ratings impact on health care Transforming health delivery Population health management Bring your own device Pharma’s changing value proposition The medical device industry & tax impact. In their report, Top health industry issues of 2013: picking up the pace on health reform, PwC summarizes these expectations as a “future [that] includes full implementation of

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Cost-conscious health consumers are adopting personal health IT

People enrolled in consumer-directed health plans (CDHPs) and high-deductible health plans (HDHPs) are more cost-conscious than those enrolled in more traditional plans, according to Findings from the 2012 EBRI/MGA Consumer Engagement in Health Care Survey from the Employee Benefit Research Institute (EBRI), published in December 2012. The logic behind CDHPs and HDHPs is that if health plan enrollees have more “skin in the game” — that is, personal financial exposure — they’ll behave more like health “consumers.” By 2012, 36% of employers with over 500 employees offered either HRA- or HSA-eligible plans. About 15% of working age adults are enrolled

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Physicians’ growing use of the Internet: where trust and value drive information search

“The Internet will have a profound effect on the practice and business of medicine. Physicians, eager to provide high-quality care and forced by competition to offer online services, will introduce e-mail and patient-friendly Web sites to improve administrative services and manage common medical conditions. Patients will identify more helath information online and will take more responsibility for their care. The doctor/patient relationship will be altered. Some aspects of electronic communication will enhance the bond, and others will threaten it. Patients will have access to vast information sources of variable validity. Many physician organizations are preparing for the electronic transformation, but

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The physician time-squeeze and burnout: just-in-time information is part of the solution

  One in two doctors is burned out. Physicians are seeing more patients in a day and spend less time with each of them. This leads to job burnout, and greater probability for medical errors and eventual liability challenges, along with feeling pushed toward early retirement. In a study published in August 2012 in the Archives of Internal Medicine, Mayo Clinic researchers learned that physicians are more burned out than workers in any other profession. And those at greatest risk of “being on a hamster wheel,” as Dr. Jeff Cain, president-elect of the American Academy of Family Physicians describes the scenario, are primary

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Nurses, pharmacists and doctors rank top in honesty, says Gallup poll

  Nurses, pharmacists and doctors rank tops with Americans when it comes to honesty and ethics. Most people also rate engineers, dentists, police officers, clergy and college teachers as high on honesty metrics. Lawmakers (THINK: Congress) and car salesman fall to the bottom of the honesty-and-trust roster, who only 1 in 10 Americans believe act with honesty and integrity. Other low-ranking professions on this list are HMO managers, stockbrokers, and folks in the advertising business. Welcome to this year’s Gallup Poll on consumers’ perceptions of honesty and ethics in 22 professions in the U.S. Gallup measures six health care professions

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Americans #1 health care priority for the President: reduce costs

Reducing health care costs far outranks improving quality and safety, improving the public’s health, and upping the customer experience as Americans’ top priority for President Obama’s health care agenda, according to a post-election poll conducted by PwC’s Health Research Institute. In Warning signs for health industry, PwC’s analysis of the survey results, found that 7 in 10 Americans point to the high costs of health care as their top concern in President Obama’s second term for addressing health care issues. Where would cost savings come from if U.S. voters wielded the accountant’s scalpel? The voters have spoken, saying, Reduce payments

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No digital divide among doctors: technology enables a majority of doctors to learn and go social

Health care professionals (HCPs) have adopted smartphones and tablets faster than the man-and-woman-on-the-street. As a result, mobile devices have become an all-important channel for communicating information to all clinicians: doctors, nurses and pharmacists. Today, medical practice is “done” via computers: the chart, from MedPage Today’s survey of physicians conducted in July 2012, shows that 100% of doctors get their learning via desktop and laptop computers (THINK: continuing medical education, for example). 88% of doctors go social online, including using point-of-care tools based on MedPage’s definition of “social interactions.” 9 in 10 doctors have increased the use of the internet in

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The impossibility of being an expert: empowering physicians with new-new information

The godfather of evidence-based medicine, Dr. David Sackett, said that the practice of evidence-based medicine integrates: Individual clinical expertise A patient’s values and expectations The best available external clinical evidence. If a physician’s got the first issue covered, and a patient is very engaged in their health in full collaboration with their physician, there’s still the third issue to deal with: the proliferation of medical information and keeping up with the literature. It’s impossible to be an expert, claimed two Welsh med school professors in the British Medical Journal in an honest appraisal of the “avalanche of information.” Today, med

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Innovating health at the point-of-care: just-in-time evidence-based information

When the phrase “health care innovation” is considered, most people think about technologies like digital imaging, breakthroughs in cancer treatment, and robotic surgery. But before clinicians order or prescribe the use of any of those choices, there’s a cognitive process that gets them to that decision. It’s a cerebral mash-up of information, learned knowledge, and that special art of medicine embodied in the provider’s experience with patients, well-honed over time. How can innovation improve this process? “Healthcare innovation can be defined as the introduction of a new concept, idea, service, process, or product aimed at improving treatment, diagnosis, education, outreach, prevention and

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Elsevier’s ClinicalKey Hits the Road – a mobile healthcare search tour

There are many definitions of mobile health, and Elsevier is adding another to the list. The world’s largest medical publisher has taken its new clinical search tool, ClinicalKey, on the road. Coined the ClinicalKey Experience Tour, Elsevier is coming to a medical center near you to enable clinicians, medical librarians, and health care administrators to give ClinicalKey a spin in their hospital’s parking lot. The challenge: the amount of new medical information doubles every 5 years, while 4 in 5 physicians say they have less than five hours a month to keep up with this, according to a DoctorDirectory survey. At the same time, health care providers feel hard-pressed

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Wired health: living by numbers – a review of the event

Wired magazine, longtime evangelist for all-things-tech, has played a growing role in serving up health-tech content over the past several years, especially through the work of Thomas Goetz. This month, Wired featured an informative section on living by numbers — the theme of a new Wired conference held 15-16 October 2012 in New York City. This feels like the week of digital health on the east coast of the U.S.: several major meetings have convened that highlight the role of technology — especially, the Internet, mobile platforms, and Big Data — on health. Among the meetings were the NYeC Digital Health conference, Digital

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3 in 5 physicians would quit today if they could

Being a doctor isn’t a happy profession in 2012: 3 in 5 doctors say that, if they could, they’d retire this year. Over three-fourths of physicians are pessimistic about the future of their profession. 84% of doctors feel that the medical profession is in decline. And, over 1 in 3 doctors would choose a different professional if they had it all to do over again. The Physicians Foundation, a nonprofit organization that represents the interests of doctors, sent a survey to 630,000 physicians — every physician in the U.S. that’s registered with the AMA’s Physician Master File — in March-June

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Patients want to see the notes their doctors write about them: the power of transparency in health care

Transparency in health care can bring greater empowerment and enable more rational decision making for health consumers. Physicians acknowledge this: “We believe that increasing transparency in the health care system can be beneficial to both patients and physicians,” said J. Fred Raslton, Jr., MD, FACP, president of the American College of Physicians. There’s an indication that patients will embrace transparency in the form of accessing their physicians’ notes about them, based on the OpenNotes project research published in the Annals of Internal Medicine this week. The objective of the study was to measure the impact on doctors and patients of extending

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Personal health records and online record access – a view from the UK

  Consumers’ online access to electronic health records is growing in and outside of the U.S. — particularly evident in the U.K., where the National Health Service (NHS) patients are being given online access to their health records held by primary care providers (GPs). This program is termed “Record Access” and could morph into the larger concept of personal health records which, today, aren’t prevalent in the U.K. A new report analyzes U.K. consumers’ perceptions about online health record access called, Personal Health Records: Putting Patients in Control? The report was published in the UK by 2020health.org with support from Microsoft. The report is written

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In this Age of the Healthcare Consumer, most people want online access to doctors and health records

Just as people go online for travel planning. photo development. and financial transactions. they’re looking for health engagement with their doctors and health records online, too. Harris Interactive heralds this as The Age of the Healthcare Consumer. Harris Interactive polled U.S. adults and found that people are interested in a range of technologies for engaging in their health, arrayed in the chart: when asked which would be important for health providers to implement, consumers said (NET = very important + important): – Online medical record access to visits, Rx, test results, and history, 65%. 17% of consumers said their doctor

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More primary care office hours, lower health care costs

It’s become evident that more health care does not often lead to better health: Shannon Brownlee’s seminal book, Overtreated, uncovered the negative relationship between more health care and worse outcomes. However, when it comes to accessing primary care, more may be a good thing. In Extended Office Hours and Health Care Expenditures: A National Study, published this week in the Annals of Family Medicine, researchers found that offering longer office hours, into evenings and weekends, leads to lower total health care expenditures for patients than practices without extended hours. Extended hours are also associated with lower prescription drug and office visit

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Men get more attention in health marketing

As women are generally thought of by marketers as the Chief Health Officers of their families, images of men in health advertising and media have been fewer than their female counterparts. In 1998, Pfizer promoted Viagra through Bob Dole. In 2003, Magic Johnson represented GSK’s HIV treatment Combivir. That same year, Mike Ditka, football coach, hawked Levitra, the ED drug, for GSK. Dr. Robert Jarvik has repped Lipitor (controversially), and Bobby Labonte, a NASCAR driver, endorsed Wellbutrin XL. But since the advent of direct-to-consumer health advertising, there haven’t been as many celebrity men promoting health as there have been women. Now, it’s the

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The rise and rise of retail clinics: a growing site for primary care, everywhere

There were nearly 6 million patient visits to retail health clinics in 2009. Such visits to retail clinics rose four-fold between 2007 and 2009, according to a RAND study published in the September 2012 issue of Health Affairs. Visits for prevention versus acute care in 2009 were roughly evenly split, with 47.5% and 51.4% of people over 18 seeking prevention vs. acute care from retail clinics, respectively. The most common acute care complaints in the retail setting were upper respiratory infections, pharyngitis, otitis externa, conjunctivitis, urinary tract infections, and allergies. What’s underneath the impressive rise is important to parse out

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Nordstrom and Amazon, where are you in health care service?

When it comes to customer service, retail, banks, airlines and hotels are tops. Health care? Not so good. This sobering finding comes via PwC’s report, Customer experience in healthcare: The moment of truth. PwC pulled data from the company’s Customer Experience Radar survey of 6,000 consumers across industries. This particular analysis looks at consumers’ service views on banking, hospitality, airline, retail vs. health care providers and insurance companies. The chart shows consumers’ answers to a question of whether they are willing to report positive interactions about a customer experience. The graph shows that people are more likely to share opinions

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Physicians not doing so well – financially, socially, physically – and what it means for health reform

Physicians’ wellbeing dropped in July: while providers’ mental health stayed sound since June, it’s financial, physical and social health that’s dragging providers’ overall wellness down. QuantiaMD, the social network exclusively for doctors, launched the Physician Wellbeing Index in January 2012. The Index measures four aspects of physician-reported wellbeing: physical, mental, financial, and social health. QuantiaMD says it’s the world’s only measure of “how physicians are doing as people.” Based on the Index, QuantiaMD tailors content to meet the needs of the physicians in the social network. In July, the chart illustrates that doctors’ wellbeing slipped in 3 of the 4

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Said the EHR to the doctor, “you like me, you really like me!”

Over one-half of office-based physicians in the U.S. had adopted an electronic health record (EHR) in 2011. Among theese adopters, 85% were satisfied: 38% “very,” and 47% “somewhat.” Those are pretty good reviews considering so many came to EHRs based on the government’s HITECH incentive and not motivated purely out of intrinsic personal passion to adopt digital medical records systems. This update comes from the July 2012 Data Brief from the National Center for Health Statistic, Physician Adoption of Electronic Health Records Systems: United States. 2011. The report details survey findings from 5,232 office-based physicians who completed the mailed questionnaire in

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Converging for health care: how collaborating is breaking down silos to achieve the Triple Aim

  On Tuesday, 9 July 2012, health industry stakeholders are convening in Philadelphia for the first CONVERGE conference, seeking to ignite conversation across siloed organizations to solve seemingly intractable problems in health care, together. Why “converge?” Because suppliers, providers, payers, health plans, and consumers have been fragmented for far too long based on arcane incentives that cause the U.S. health system to be stuck in a Rube Goldbergian knot of inefficiency, ineffectiveness and fragmentation of access….not to mention cost increases leading us to devote nearly one-fifth of national GDP on health care at a cost of nearly $3 trillion…and going up.

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Self-service healthcare: patients like online and mobile access, but still want F2F time

The supply-side of healthcare DIY is growing, with the advancement of Castlight Health through its $100mm VC influx and Cakehealth’s new version for managing health spending online. Consumer demand is growing, too, for these services. But don’t get over-hyped by the healthcare, everywhere, scenario. Health citizens also demand face-to-face time with their physicians and clinicians, evidenced by a survey from Accenture titled, Is healthcare self-service online enough to satisfy patients? The answer is a clear, “no.” 90% of U.S. adults like the idea of digital health self-service, 83% want online access to personal health information, 72% want to book appointments

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Consumer Reports becomes a resource for doctor-shopping

There’s a long-held belief among us long-time health industry analysts that Americans spend more time shopping around for cars and washing machines than for health plans and doctors. Consumer Reports is betting that’s going to change, now that Consumers Union has decided to lend its valuable, trusted brand to developing report cards on physicians, having already rated hospitals and heart surgeons. CR will call their version of the doctor’s report card Patient Experience Ratings. CR has first entered the competitive medical market of Massachusetts, and has unveiled reports on 500 primary care physicians in the state. CR worked with  physician survey

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Sick of health care costs in America

9 in 10 Americans who know the health system — those with a serious illness, medical condition, injury or disability — believe that health care costs are a serious problem for the nation. This problem has gotten worse over the last 5 years, according to 70% of sick Americans. The Sick in America Poll, from National Public Radio, Robert Wood Johnson Foundation, and the Harvard School of Public Health, was released May 2012. The survey presents a picture of the 27% of Americans who use the health system and, as a result of their illness or disability, encounter financial challenges. When

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The pharmaceutical landscape for 2012 and beyond: balancing cost with care, and incentives for health behaviors

Transparency, data-based pharmacy decisions, incentivizing patient behavior, and outcomes-based payments will reshape the environment for marketing pharmaceutical drugs in and beyond 2012. Two reports published this week, from Express Scripts–Medco and PwC, explain these forces, which will severely challenge Pharma’s mood of market ennui. Express-Scripts Medco’s report on 9 Leading Trends in Rx Plan Management presents findings from a survey of 318 pharmacy benefit decision makers in public and private sector organizations. About one-half of the respondents represented smaller organizations with fewer than 5,000 employees; about 20% represented jumbo companies with over 25,000 workers. The survey was conducted in the

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A health plan or a car: health insurance for a family of four exceeds $20K in 2012

The saying goes, “you pays your money and you makes your choice.” In 2012, if you have a bolus of $20,700 to spend, you can choose between a health plan for a family of four, or a sedan for the same family. That’s the calculation from the actuaries at Milliman, whose annual Milliman Medical Index is the go-to analysis on health care costs for a family of four covered by a preferred provider organization plan (PPO). While the 6.9% annual average cost increase is lower than the 7.3% in 2011, it is nonetheless, a record $1,335 real dollar increase at

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Improving health care through Big Data: a meeting of the minds at SAS

Some 500 data analytics gurus representing the health care ecosystem including hospitals, physician practices, life science companies, academia and consulting came together on the lush campus of SAS in Cary, North Carolina, this week to discuss how Big Data could solve health care’s Triple Aim, as coined by keynote speaker Dr. Donald Berwick: improve the care experience, improve health outcomes, and reduce costs. Before Dr. Berwick, appointed as President Obama’s first head of the Centers for Medicare & Medicaid Services, Clayton Christensen of the Harvard Business School, godfather of the theory of disruptive innovation in business, spokee about his journey

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Patients want to collaborate with physicians, but are reluctant to do so

“Knowing they may need to return at some later time, patients felt they were vulnerable and dependent on the good will of their physicians. Thus, deference to authority instead of genuine partnership appeared to be the participants’ mode of working,” asserts a study into physician-patient relationships published this week in Health Affairs. The study’s title captures the top-line research finding Authoritarian Physicians and Patients’ Fear of Being Labeled ‘Difficult’ Among Key Obstacles To Shared Decision Making.  Researchers at the Palo Alto Medical Foundation Research Institute analyzed data on patients participating in focus grooups, from the age of forty and over, from

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It’s the prices and the technology, stupid: why U.S. health costs are higher than anywhere in the world

The price of physician services, proliferation of clinical technology and the cost of obesity are the key drivers of higher health spending in the U.S., according to The Commonwealth Fund‘s latest analysis in their Issues of International Health Policy titled, Explaining High Health Care Spending in the United States: An International Comparison of Supply, Utilization, Prices, and Quality, published in May 2012. The U.S. devotes 17.4% of the national economy to health spending, amounting to about $8,000 per person. The UK devotes about 10%, Germany 11.6%, France, 11.8%, Australia 8.7%, and Japan, 8.5%. On the physician pay front, primary care

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For consumers, time is money and life when it comes to health care

Once upon a time, patient satisfaction with visits to doctors’ offices used to be a function of bedside (exam room) manner, demeanor and responsiveness of the reception and insurance staff, and the age of magazines in the waiting room. Today, waiting time is a key factor, and social media is raising expectations around response time in health care. See the first chart, based on data from PwC’s survey, Social Media “Likes” Healthcare, published in late April 2012. The poll found that when U.S. adults use social media in healthcare, at least 4 in 10 people want complaints and information requests responded to

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Your doctor’s appointment on your phone: out of beta and into your pocket

You can now carry a doctor with you in your pocket. Two top telehealth companies that support online physician-patient visits have gone mobile. This upgrade was announced this week at the 2012 American Telemedicine Association conference, being held in San Jose, CA. In enabling mobile physician visits, American Well and Consult A Doctor join Myca, which has offered mobile phone-based visits for clients for at least two years to employer clinic customers. In April 2010, my report, How Smartphones Are Changing Healthcare for Consumers and Providers, talked about Myca’s work with Qualcomm: the telecomms company armed traveling employees with mobile phones that could connect

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The economics of being a practicing physician: greater frustration, lower income, more defensive

One-half of physicians believe they’re not fairly compensated for their work – in particular, those working in primary care. Only 11% of doctors considering themselves “rich.” Medscape’s 2012 Physician Compensation Report compiled data from over 24,000 U.S. physicians across 24 specialties and found the bulk of physicians to see themselves working harder and 1 in 4 making less money than last year. This has led to growing frustration and worry, where some physicians are resenting the large pay gap between specialists and primary care. That frustration looks poised to increase with doctors concerned that accountable care will further eat into

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Connected Health: countries’ vary in their health IT connectedness, but US patients are ready, willing and welcoming EHRs

How electronically connnected and communicative are nations’ health information infrastructures? Accenture has answered that question in its report, Making the Case for Connected Health. Accenture built a “connected health maturity index,” analyzing a nation’s level of health information exchange among users along with their level of health IT adoption among specialists and primary care doctors. Adoption was defined across four HIT functions: administrative tools, electronic patient notes, electronic alerts/reminders, and computerized decision support systems. Health information exchange was defined across seven connectivity dimensions: electronic communications, e-notifications, e-referrals, e-access to clinical data about patients who see a different provider, e-prescribing, and

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iPads and health care – health IT managers slow down physicians’ clinical adoption

Doctors are using iPads in huge numbers for personal life project management. 80% of doctors are excited about using them in clinical practice. But when it comes to clinical applications, don’t confuse physicians’ desire for mobility with their current use of iPads in everyday practice. What’s surprising is the “why” behind that phenomenon. It’s not a lack of desire; to a large extent, it’s a hospital-based system that’s not listening to physician demand for seamless mobility that fits with real-life workflow. This was the light-bulb-over-the-head finding of Gregg Malkary of Spyglass Consulting. Gregg recently complete 100 in-depth interviews with switched-on doctors to

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